Testing interventions for autism spectrum disorder

How do you know whether an intervention for autism spectrum disorder (ASD) will work? First you need to be clear about the claims being made about the intervention and what it can do for your child. Next is finding out whether these claims have been properly tested, and whether the tests have provided any reliable proof that the intervention really works.

Why testing the evidence matters

Any treatment for autism spectrum disorder (ASD) will make a claim about how it will help your child. It might claim to improve your child’s symptoms, teach skills or even ‘cure’ ASD. Testing the intervention involves checking what it claims to do against what happens in reality, when real people use the intervention. This process is also called ‘evaluating’ the intervention.

Essentially, testing matters because – conducted properly – it can tell you whether the intervention does what it’s supposed to do.

When you’re choosing a treatment or therapy, look for ‘evidence-based’ approaches – that is, interventions that have scientific evidence to show they work for children with autism spectrum disorder (ASD). Be cautious and use your judgment when considering treatments or interventions that have not yet been scientifically tested.

Scientific tests and autism spectrum disorder interventions

Whether it’s a new skin cream, new computer software or interventions for autism spectrum disorder (ASD), most people agree that the best way to test something is to use a scientific approach. Science provides the best tools we have to conduct a fair test of whether something works.

Science tests interventions by:

clearly describing the behaviour or symptoms that the treatment is supposed to change

clearly explaining how the treatment is implemented

clearly identifying how change in behaviour or symptoms will be measured

controlling other possible causes of change in the behaviour or symptom – for example, changing only one thing at a time, having a ‘control’ or ‘comparison’ group, or testing in a way that can’t be influenced by opinions or beliefs

repeating the test to see whether the same results are found, preferably by other researchers.

When it’s done well, this means that the test is fair and the test results are reliable.

Certain things don’t count as a test:

personal testimonies, even those from other parents

the word of an ‘authority figure’ – professionals can give conflicting advice about a treatment

the collective opinion of a particular group of professionals.

About research and publication

Once researchers do a study to test an intervention, they might write a paper about the study and its results and submit the paper for publication in a journal.

Any worthwhile journal will ‘peer review’ papers as part of its publication process. This means that the paper is sent off to other researchers who are given no information about who or where the study has come from. The researchers look at the study’s data, methodology, results and conclusions. If they approve the study based on these, the paper can be published.

There are two important points to note here. In the scientific community, weight is given to tests results that have been peer reviewedand published. If studies or tests have not been peer reviewed or published, they don’t carry much weight.

Also, a single study rarely gets much attention. But if several studies point to the same results, those results begin to gain acceptance.

Still, things change in science. Over time, new studies might challenge the accepted beliefs about an intervention. This is a good thing – the research process is about constant questioning, so that existing therapies can be improved or better ones can be developed.

Sometimes researchers publish a ‘systematic review’ about an intervention. This means that they look at all studies done on the intervention, carefully pulling them together and comparing the results to find and publish some overall conclusions about the intervention.

Untested autism spectrum disorder interventions

Properly testing autism spectrum disorder (ASD) interventions isn’t always as easy as it sounds. This is why there’s a lot of confusion about what does and doesn’t work.

Also, not all people working in ASD research take a scientific approach to their work. This is one reason why fad therapies come about and claims about ‘cures’ are made and gain attention.

Example: the leaky gut theory of autism spectrum disorder
It has been observed that a proportion of children with ASD seem to have gut problems like food allergies or a ‘leaky gut’ (where chemicals leak from the gut into the nervous system). This observation has led to various ideas or theories about some gut problems being unique to ASD – even ‘causing’ ASD. In turn, this has led to untested or poorly tested interventions based on changing the child’s diet.

In an example like this, more testing is needed to find out whether:

‘leaky gut’ or food allergies are unique to ASD (or a major cause of ASD)

treatment that involves changes to diet improves any or all symptoms of ASD.

Our Parent Guide to Therapies offers reliable information about a wide range of therapies and interventions for children with autism spectrum disorder (ASD). Each guide gives an overview of the therapy, what research says about the therapy and the approximate time and costs involved.

Roberts, J.M.A., & Prior, M. (2006). A review of the research to identify the most effective models of practice in early intervention of children with autism spectrum disorders. Canberra: Australian Government Department of Health and Ageing.